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目的:探讨胰十二指肠切除术后发生胰瘘的危险因素。方法:回顾性分析2014年1月至2018年12月间安徽医科大学第一附属医院肝胆胰外科中心收治的185例行胰十二指肠切除术患者的临床资料，采用单因素和多因素logistic回归分析导致术后胰瘘发生的危险因素。结果:185例患者中37例术后发生胰瘘，胰瘘发生率为20.0%，其中34例(18.4%)为B级胰瘘，3例(1.6%)为C级胰瘘，与术后胰瘘直接相关死亡2例(5.4%)。B、C级术后胰瘘患者住院时间明显增长，医疗费用明显增加。单因素分析结果显示，胰管直径≤3 mm 、胰腺质软和术后白蛋白≤30 g/L(χn 2值分别为7.236、6.948、8.063，n P值均<0.05)是胰十二指肠切除术后胰瘘发生的危险因素；多因素分析结果显示，胰管直径≤3 mm、胰腺质软和术后白蛋白≤30 g/L是术后胰瘘发生的独立危险因素(n OR值分别为0.401、0.629、0.326，95%n CI分别为0.167～0.968、0.411～0.963、0.150～0.711，n P值均<0.05)。术后胰瘘患者中位生存时间为827.0 d，1年生存率为94.7%，3年生存率为35.8%。术后胰瘘与患者长期预后无显著相关性(χn 2＝1.367，n P＝0.242)。n 结论:胰管直径过小(≤3 mm)、胰腺质软和术后白蛋白较低(≤30 g/L)的患者预示着胰十二指肠切除术后较高的胰瘘发生率，术后胰瘘不会显著影响患者的长期生存。“,”Objective:To analyze the risk factors for postoperative pancreatic fistula after pancreaticoduodenectomy (PD).Methods:The clinical data of 185 patients undergoing PD who were admitted to the Hepatobiliary and Pancreatic Surgery Center of First Affiliated Hospital of Anhui Medical University from January 2014 to December 2018 were retrospectively analyzed. Risk factors for pancreatic fistula after PD were investigated using univariate and multivariate logistic regression analyses.Results:Among 185 patients, pancreatic fistula occurred in 37 patients after PD, and the incidence was 20.0%. Of 34 patients (18.4%) developed grade B pancreatic fistula, and 3 patients (1.6%) developed grade C pancreatic fistula. There were two deaths directly related to postoperative pancreatic fistula (5.4%). Patients with grade B and C postoperative pancreatic fistula had significantly increased hospitalization time and medical expenses. Univariate analysis identified that pancreatic duct diameter ≤3 mm, soft pancreas and serum albumin ≤30 g/L(χn 2=7.236, 6.948, 8.063, all n P<0.05) were risk factors for pancreatic fistula after PD. Multivariate logistic regression analysis identified that pancreatic duct diameter≤3mm, soft pancreatic texture and serum albumin ≤30 g/L (n OR=0.401, 0.629, 0.326, 95% n CI 0.167-0.968, 0.411-0.963, 0.150-0.711, all n P<0.05) were independent risk factors for pancreatic fistula after PD. Postoperative pancreatic fistula patients had a median survival time of 827.0 days, 1-year survival rate was 94.7%, and a 3-year survival rate was 35.8%. There was no significant correlation between postoperative pancreatic fistula and postoperative survival(χn 2=1.367, n P=0.242).n Conclusions:Patients with a smaller pancreatic duct diameter (≤3 mm), soft pancreatic texture, and low postoperative albumin(≤30 g/L) may have a high incidence of pancreatic fistula after PD. Postoperative pancreatic fistula did not significantly affect the patients′ long-term survival.